Information Collection

CDRH Customer Satisfaction Survey

IC 250074 under ICR 202204-0910-001 · OMB 0910-0360.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0360 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Survey Quesionnaire.docx	Other-Survey Instrument
Survey Quesionnaire.docx	Other-Survey Instrument
0360 OMB Approval Memo - CDRH Customer Satisfaction Survey 2021.docx OMB approval memo	IC Document
0360 OMB Approval Memo - CDRH Customer Satisfaction Survey 2021.docx OMB approval memo	IC Document

IC Title:

CDRH Customer Satisfaction Survey

Agency IC Tracking Number:

CDRH

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Instrument			Survey Quesionnaire.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB approval memo	0360 OMB Approval Memo - CDRH Customer Satisfaction Survey 2021.docx	11/03/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.